Time to wake up to social care reform


By Dr Eleanor Roy, CIPFA Health and Social Care Policy Manager

The plight of social care off the back of this pandemic cannot be understated. At every turn, this vital sector, which looks after the most vulnerable members of our society, has been treated like the public sector’s poor relation.

The government was quick to call on social care to support the response to the pandemic, with policies quickly put in place to get people out of hospitals and into care settings to free up NHS capacity.

Despite this, financial support for this essential front line service has so far been distinctly lacking. That’s why today’s findings from ADASS are intensely troubling, but unsurprising.

ADASS’s Annual Budget Report has found that only 4% of Adult Social Services Directors are confident their budgets are sufficient to meet statutory duties.

Let that sink in. Four per cent. That is a figure that should make us sit up and take notice – this time last year it was 35%. Without immediate additional, targeted support, vital social care services are at tremendous risk.

To date, the government has provided £3.2bn of funding to local authorities to cover costs of services they are providing in response to COVID-19. However when this figure is quoted in briefings, what is often glossed over is the fact that this covers the entirety of local government services, not just social care.

While it’s true government has also provided a £600m Infection Control Fund, this is to support the private provider market. Local authorities face a further administrative burden managing a fund from which they largely do not benefit. The fund has already been criticised for being overly bureaucratic. We have heard that some care homes are refusing the offer of funding, as the cost of meeting the conditions would be more than they would receive.  So while this is well-intended, perhaps direct support for private providers (as has been done for other areas of business) – and informed by their needs - would have been more useful?

None of this comes anywhere close to the estimated £6.6bn of additional costs related to COVID-19 reported for adult social care alone. 

It’s high time that government recognised it is more than just the direct costs of the pandemic that impact on service budgets – lost income and ability to meet planned savings are also crucial factors in the financial sustainability of these essential services going forward.

The shock of this huge estimated gap comes on top of existing challenges that were facing the sector before the pandemic struck. A decade of austerity has resulted in social care services that are over-stretched and under-resourced.

Reform of adult social care funding is decades overdue, meaning the sector entered the current crisis already on the back foot. Weaknesses in the sector’s resilience have not only been revealed by COVID-19, they’ve been exacerbated.

It is time to take action on social care funding reform and in doing so, it is essential that:

  • sufficient funding is provided to mitigate the impact of COVID-19 on social care services – not only on direct costs, but also planned savings and income
  • such reform should be strategically informed, financially sustainable, equitable and underpinned by a clear understanding of the challenges of funding social care
  • until a long-term solution to the issue of social care funding can be implemented, adequate funding is provided to put the sector on a financially sustainable footing and enable it to withstand any future shocks.

The experience of COVID-19 and its impact on social care must act as a catalyst for reform. I can only hope that this will serve as the wake-up call government clearly needs.

This article first appeared in the MJ.

Further reading

If you are looking for further comment, insight, support and resources relating to social care, our Building Sustainable Social Care page provides information on overall context and how CIPFA can help. You can also find our reports, publications and help for the very considerable challenges, even pre-COVID-19, that professionals face.  

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